Rhabdomyolysis in pontocerebellar hypoplasia type 2 (PCH-2)
Received 23 April 2007; received in revised form 26 July 2007; accepted 1 August 2007.
Abstract
Pontocerebellar hypoplasia type 2, an autosomal recessive neurodegeneration with prenatal onset, is characterised by progressive microcephaly and chorea/dystonia and has not previously been associated with muscular involvement. The gene associated with PCH-2 is unknown. An episode of rhabdomyolysis is reported in two non-related children with PCH-2, fatal in one, precipitated by intercurrent disease. Muscle biopsies in two other PCH-2 patients, and in one rhabdomyolysis patient whose biopsy antedated this complication showed areas of myofibrillar disruption or necrosis. Postmortem muscle sampled in another case without neuromuscular symptoms revealed focal necrosis, regenerating small fibres and upregulation of HLA-ABC. Random serum creatine kinase values in six other PCH-2 patients without clinical signs of neuromuscular involvement were increased in four. Collected data provide preliminary evidence of a subclinical myopathy associated with PCH-2.
aDepartment of Paediatric Neurology, Room # G8-211, Emma Children’s Hospital/Academic Medical Centre, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
bDepartment of Neuropathology, Academic Medical Center, University of Amsterdam, The Netherlands
dMurdoch Children’s Research Institute, Melbourne, Australia
eChildren’s Hospital at Westmead, Westmead, Australia
fDiscipline of Paediatrics and Child Health, University of Sydney, Sydney, Australia
gBristol Children’s Hospital, Bristol, United Kingdom
Corresponding author. Address: Department of Paediatric Neurology, Room # G8-211, Emma Children’s Hospital/Academic Medical Centre, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands. Tel.: +31 20 5667508.
ABSTRACT